NOSOCOMIAL EPIGLOTTITIS ASSOCIATED WITH PENICILLIN-RESISTANT AND CEPHALOSPORIN-RESISTANT STREPTOCOCCUS-PNEUMONIAE BACTEREMIA

We cared for a 4-year-old male with nosocomially acquired epiglottitis caused by Streptococcus pneumoniae. He had been receiving ceftazidime therapy when this infection was recognized. The S. pneumoniae isolate was of serotype 15B and was resistant to beta-lactam antibiotics, cep halosporins (including those with extended spectra), and trimethoprim- sulfamethoxazole. Clinicians and clinical microbiologists must be awar e that cephalosporin susceptibility may no longer be assumed for penic illin-resistant S. pneumoniae isolates and that susceptibility testing for the extended-spectrum cephalosporins should be performed whenever this species is isolated from a normally sterile body fluid.